Clark Atlanta University
Prospective Student-Athlete Information Form

NOTE: This form is not an official university application.
This form will be used by the coaching staff to help determine prospective student-athletes.
NCAA rules prohibit coaches from contacting freshmen and sophomores in high school.

Personal Information
Last Name First Name MI.
E-Mail Home Phone
Country Sex (M/F)
Address
City State Zip
Date of Birth (MM/DD/YY) Date of Grad (MM/YY)
Height (ft/in) Weight (lbs)

Ethnic Background (optional)

Non-Athletic Activities

Student Body Officer

Editor, School Publication

Field of Study

Class President

National Honor Society

Other

Academic Information
Class Rank out of     G.P.A.
Test Scores:
SAT: Date (MM/DD/YY) Verbal Math
ACT: Date (MM/DD/YY) Composite  
Achievement
Scores:		    
High School Name Year in School (fr/so/ju/sr)
Street City State Zip
Phone
Guidance Counselor

Athletic Background
Sports Position Vars. Letter Honors
Notes:

Interest Level

Please select the level that represents your present interest in Clark Atlanta University

Other Colleges of Interest

Do you intend to apply for financial assistance to attend college (optional). Yes No